Wednesday, June 25, 2014

Study Finds Minimal Benefit for Oxytocin in Patients With Early Psychosis

What appears to be the first randomized controlled trial of oxytocin nasal spray for patients with early psychosis found no benefit over placebo with regard to social functioning—although a follow-up analysis looking at dosing suggests that increased use of oxytocin nasal spray was associated with reductions in negative symptoms. The findings appear in a study published online in Schizophrenia Bulletin.

Oxytocin is a hormone that has been associated with empathy and other factors critical to social functioning. Some preliminary studies have suggested that oxytocin might benefit patients with psychosis, especially with regard to the cognitive and social deficits experienced by schizophrenia patients.

Researchers at the Brain and Mind Institute at Australia's University of Sydney conducted a double-blind, randomized, placebo-controlled trial in which 52 individuals aged 16 to 35 diagnosed with an early psychosis schizophrenia-spectrum illness received oxytocin or placebo nasal spray twice-daily for six weeks, combined with group social cognition training. Assessments were conducted at baseline, post-treatment, and three-month follow-up. Primary outcomes were scores on standardized tests measuring social cognition, social functioning, and negative symptoms. Secondary outcomes included self-report and behavioral assessments of social cognition, symptom severity, and social functioning. The data analysis showed that on all primary and secondary outcomes, there was no benefit of oxytocin nasal spray treatment compared with placebo. However, additional exploratory analysis looking at dosing suggested that increased use of nasal spray was associated with reductions in negative symptoms.

“Although the results suggest no benefit of oxytocin treatment, results also highlight an urgent need to consider nasal spray delivery and dose-related variables for future clinical trials," the researchers said.

Psychiatrist Stephen Marder, M.D., of the Semel Institute for Neuroscience at UCLA, has conducted research using oxytocin to study its effects on empathy. Commenting on the Schizophrenia Bulletin study, Marder said that though the findings are disappointing, the results are important for clarifying when and how oxytocin might be useful. “All of the subjects in the trial received social cognition training,” he said. “It's possible that this was very effective, and oxytocin could add little to it.” He added that it could be that oxytocin loses some of its effectiveness when it is administered chronically, as in this study. “As the authors indicate, more work should be done to clarify the best dose of oxytocin and when it should be administered."

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